Healthcare Provider Details

I. General information

NPI: 1033677844
Provider Name (Legal Business Name): SOCAL SURGICAL CENTER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/11/2019
Last Update Date: 02/05/2020
Certification Date: 02/05/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1901 SOLAR DR STE 110
OXNARD CA
93036-2642
US

IV. Provider business mailing address

1901 SOLAR DR STE 110
OXNARD CA
93036-2642
US

V. Phone/Fax

Practice location:
  • Phone: 213-359-3050
  • Fax: 213-359-3050
Mailing address:
  • Phone: 805-742-4900
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. ANDREW LANGROUDI
Title or Position: CEO
Credential: DPM
Phone: 805-742-4900